- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $4,241.22 / $13,841.56
| Facility | | $1,506.15 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,252.94 / $3,266.13 / $5,731.84
| Facility | | $2,252.94 | $3,266.13 | $5,731.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.98 / $527.08 / $1,152.30
| Facility | | $226.98 | $527.08 | $1,152.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.27 / $1,062.42 / $1,550.57
| Facility | | $569.27 | $1,062.42 | $1,550.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |